Hepatitis C transmission occurs primarily through exposure to infected blood. This exposure exists in the context of injection drug use, blood transfusion before 1992, solid organ transplantation from infected donors, unsafe medical practices, occupational exposure to infected blood, birth to an infected mother, high-risk sexual practices with an infected person, and intranasal cocaine use. The incidence of new HCV infections appears to have declined significantly in the late 1980’s, perhaps related to behavior changes due to concern about transmission of other blood borne diseases. Transmission from blood products and organ transplants was virtually eliminated by the introduction of a more sensitive test for antibody to HCV (HCVab) in mid-1992.

In general, studies have shown that 60-85 percent of persons with acute HCV infection will develop chronic infection. HCV replicates preferentially in hepatocytes but is not directly cytopathic, thus often leading to persistent infection. The estimated prevalence of HCV in the United States is at least 1.8% of the whole population, making HCV the most common chronic blood-borne infection nationally. High anti-HCV seroprevalence rates from (15 to 90 percent) have been documented in specific subpopulations, including a rate of about 70 to 80 percent in injection drug users. Oregon has documented a seroprevalence rate of 30 percent of inmates entering the prison system.

Risk of Transmission in Correctional Institutions is Low
Based upon what is known about transmission rates and the natural progression of hepatitis C in the community, the rate of seropositivity found among inmates in the Department of Corrections represents infection that was transmitted before incarceration. Transmission of hepatitis C among inmates while they are incarcerated is estimated to be low because of the documented success the Department has with random drug urinalysis, interdiction of contraband, and the low incidence of acute infections with other blood borne pathogens, and surveillance of all forms of prohibited activity.

Standard precautions is the term used for the procedures which prevent transmission of blood borne communicable diseases caused by exposure to blood or other body fluids. These procedures effectively prevent transmission of hepatitis C. Since the HIV/AIDS epidemic, the workplace in correctional settings has been modified to include new equipment, supplies and procedures that effectively incorporate additional protections against blood and body fluid exposure, and rapid response to every exposure to blood.

Oregon Department of Corrections has a well established program for advocating voluntary screening and medical evaluation.